| NPI | 1558766790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL A WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 231H00000X Audiologist |
| 207RG0100X Internal Medicine, Gastroenterology | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2025-05-20 |